Sirin Nermin Gorkem, Kurt Elif, Ulasoglu-Yildiz Cigdem, Kicik Ani, Bayram Ali, Karaaslan Zerrin, Bebek Nerses, Baykan Betul, Demiralp Tamer, Gurses Candan
Departments of Neurology and Clinical Neurophysiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey, Aziz Sancar Institute of Experimental Medicine, Department of Neuroscience, Istanbul University, Istanbul, Turkey.
Aziz Sancar Institute of Experimental Medicine, Department of Neuroscience, Istanbul University, Istanbul, Turkey, Hulusi Behçet Life Sciences Research Laboratory, Istanbul University, Istanbul, Turkey.
Epileptic Disord. 2020 Oct 1;22(5):623-632. doi: 10.1684/epd.2020.1210.
The pathophysiology of switch-of lateralization and bilateral temporal asynchrony, which are scalp EEG ictal propagation patterns (iPP) in temporal lobe epilepsy (TLE), is poorly understood. We aimed to analyse functional connectivity (FC) of the temporal lobe and related areas in patients with TLE with iPP (iPP-TLE) and without iPP (non-iPP TLE). Twelve patients with iPP-TLE, 13 patients with non-iPP TLE, and 13 healthy controls (HC) underwent resting-state functional MRI (fMRI). Seed-based FC was analysed between the homologous insulae, hippocampi, amygdalae, parahippocampal, superior temporal, and middle temporal gyri. FC was reduced between homologous temporal lobe areas in patients with TLE compared with HCs. Patients with non-iPP TLE displayed decreased FC between the homologous parahippocampal and superior temporal gyri, and patients with iPP-TLE had lower FC between the homologous insulae, parahippocampal and superior temporal gyri compared with HC. Furthermore, patients with iPP-TLE tended to have lower FC between the bilateral insulae when compared with patients with non-iPP TLE. Reduced FC of interhemispheric connections between temporal lobes and related areas might be an adaptive change to protect contralateral areas in seizure propagation. The insula showed decreased FC between two hemispheres in patients with iPP-TLE, assuming a role in ictal scalp propagation pattern changes in TLE.
作为颞叶癫痫（TLE）发作期头皮脑电图传播模式（iPP）的偏侧化转换和双侧颞叶不同步的病理生理学机制，目前了解甚少。我们旨在分析有iPP的TLE患者（iPP-TLE）和无iPP的TLE患者（非iPP-TLE）颞叶及相关区域的功能连接（FC）。12例iPP-TLE患者、13例非iPP-TLE患者和13名健康对照者（HC）接受了静息态功能磁共振成像（fMRI）检查。基于种子点的FC分析在同源脑岛、海马、杏仁核、海马旁回、颞上回和颞中回之间进行。与HC相比，TLE患者同源颞叶区域之间的FC降低。非iPP-TLE患者在同源海马旁回和颞上回之间的FC降低，与HC相比，iPP-TLE患者在同源脑岛、海马旁回和颞上回之间的FC更低。此外，与非iPP-TLE患者相比，iPP-TLE患者双侧脑岛之间的FC往往更低。颞叶及相关区域半球间连接FC降低可能是在癫痫发作传播中保护对侧区域的一种适应性变化。iPP-TLE患者两半球之间脑岛的FC降低，提示其在TLE发作期头皮传播模式变化中起作用。
